Sexual Dysfunction - ASCO curriculum

Body changes from cancer surgery, chemotherapy, or radiation therapy
Hormone changes
Fatigue
Pain
Nausea and vomiting
Medications that can reduce libido (sex drive)
Fear of recurrence (return of the cancer)
Stress
Depression
Anxiety

Sexual problems experienced by people with cancer generally fall into one of four categories:

Desire disorders, which is the decrease or loss of sexual fantasies and desire
Arousal disorders, which include the inability to achieve or maintain sexual arousal, such as lubrication or swelling in women and an erection in men
Orgasmic disorders, which is the delay or absence of orgasm following normal arousal, such as premature ejaculation in men
Pain disorders, which is genital pain during sexual intercourse

Diagnosis

It is important to have an honest discussion about sexual problems with your doctor. Often, there are solutions to these common sexual problems. Your doctor may ask about the following:

Your sexual activity before cancer
How cancer has changed your sexual activity
Any existing or potential problems in your relationship

Your doctor can help explain typical reactions to a given cancer treatment and, in some cases, refer you to a health-care professional who specializes in treating sexual dysfunction.

Managing sexual side effects

For women who experience vaginal pain or dryness, the following suggestions may help:

Hormone replacement therapy (only for cancers that will not be affected by hormone treatments)
Vaginal moisturizers or lubricants
Vaginal dilators, which help gradually expand the vagina
Anesthetic gels (to help with pain)

For men with erection problems, the following may help to increase sexual desire and potency:

Medications to help men achieve and maintain an erection, such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra)
Penile implants
Medications to increases blood flow to the penis, such as intraurethral alprostadil (Caverject, Edex, or Muse) and intracavernous papaverine (sold under multiple brand names)

Talk with your doctor about the potential risks and side effects before using any medication.

More Information

Cancer.Net: Body Image Sexuality

Cancer.Net: Managing Side Effects

Cancersymptoms.org: Sexual Dysfunction